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Scenario: Your hospital has an opportunity to participate with an Accountable Care Organization (ACO) contract with 50,000 ACO patients.  The ACO patient population expects about 5,000 avoidable hospitalizatio

Healthcare Financial Management and Economics

Week 4 Assignment

Assignment: Supply of Primary Care Workforce

 Scenario: Your hospital has an opportunity to participate with an Accountable Care Organization (ACO) contract with 50,000 ACO patients.  The ACO patient population expects about 5,000 avoidable hospitalizations per year with a potential savings of $50 million, which will be shared 50% revenue to the insurer and 50% revenue to the hospital.  The ACO patient population will require an average of 6 office visits per year, and 300,000 total office visits will need to be supplied by your primary care workforce.

 

To prepare for this Assignment:

Based on the scenario and financial data provided by the course instructor, conduct a financial projection (revenues, expenses, and profit) which analyzes the efficiency in the supply of health services.

The Assignment:

In a 2- to 3-page Word document that includes tables and/or calculations, make recommendations on the following: 1) number of physicians and nurse practitioners; 2) reimbursement method: salary or fee-for-service; 3) recommendations for financial incentives to address challenges of supplier induced demand and ensure efficiency. Interpret the net profit from the ACO contract based on your recommendations. Support your recommendations with rationale, including how the financial calculations impacted your recommendations.

Financial Data


ACO revenue:

 

Number of ACO patients

50,000

 

 

Potential savings:

 

Number of avoidable hospitalizations per patient

0.1

Total avoidable hospitalizations per year

5,000

Cost per avoidable hospitalization

$10,000 

Total cost of avoidable hospitalizations

$50,000,000 

 

 

Demand for
healthcare/utilization:

 

Number of office visits per patient

6

Total office visits per year

300,000

 

 

Supply of
workforce/expense:

 

Employed providers (salary)

 

Physician
salary per year

$200,000 

Nurse
practitioner salary per year

$100,000 

Contracted providers
(fee-for-service)

 

Physician
fee per visit

$100 

Nurse
practitioner fee per visit

$50 

 

 

Productivity:

 

Physician visits per year

3,000

Nurse practitioner visits per year

2,000

 

 

Financial
incentives:

 

Salary bonus to ensure efficiency

10%

Bonus fee per visit to ensure efficiency

$1 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

        

        

        

                   

        

        

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